201110930 六、發明說明： 【發明所屬之技術領域】 本發明係關於一種骨骼固定裝置，可供穩定桿件固定於 骨骼或椎骨内。骨骼固定裝置包含固定元件；容納件，可供 容納骨骼固定元件之頭部，和容納穩定桿件，連接於固定元 件。固定元件係樞動連接於容納件，可藉經由壓力元件施壓 於頭部，以固持其角度。固定元件和壓力元件可從容納件頂 端插入，而壓力元件一旦插入後，彈簀元件抵制壓力元件經 頂端脫出。 【先前技術】 US 5,716,356號記載一種多軸式骨胳螺釘，包含螺釘元 件和容納件，後者樞接於螺釘元件和壓力元件，對螺釘元件 的頭部施壓，以固持螺釘元件和容納件間之角度。容納件呈 U形通道，以容納穩定桿件。壓力元件包括圓筒形凹部， U形通道對齊，把桿件容納其内。為把壓力元件包持在盥口 ^道對齊之位置，壓力元件擠穿過容納件所設腔孔:以 固持其位置。 US 20_080420 A1記載一種多抽式骨路螺釘包 ，基部構件把敎元件扣持在容納構件 u相件施壓於螺釘元件之頭部。冠部元件包括 二之止動表面，有助於保持冠部元件於容納 =底m容路：r所謂底部加載式螺釘，即螺釘元件 WO 2006/116437 A2記載-種骨縣固定器，供脊 配署式骨路螺釘形式’包含螺釘元件、罩殼'、套筒和 罩殼内之筒夾，供施壓於螺釘元件之頭部。蟫釘二株 成於套ί另外，扣持肋條可形成於罩殼，而長孔形 通常’上述_之多軸式骨賴釘，_如峽商· 201110930 組裝狀態運送。在此狀態下，特殊螺釘元件，例如具 長度和特定螺紋形式的幹部直徑之螺釘元件，連^六 力元件即配置其内’故不致脫出。外科手術可^用 必要數量和型式之此類預組裝多軸式骨骼螺 = 套植入體提供。 ㈣先以全 你知錄式骨闕釘在預組裝狀_，壓力元件是在可 ^碩。Ρ在容納件内自由樞動之位置。在手術當中的某些 下，不需要有如此不拘限的樞動。 /、— 4 【發明内容】 由外供—種骨路固定裝置’其中組件可 脉組裝。料，f麵妓置倾供手術當中 雜ί目目丨的係按照_請專利範圍第1項固定裝置解決。進-^發展則列於申請專利範圍附屬項。 減少置只有少數組件。組件係簡單設計。如此可 之前，置。組件製造後，在螺針插入骨路内 多軸式骨二=骨絡。是故， 其任何，理，於手術之前或當中為5仃-疋外科醫師或 要，定f f之模組系統，可視實際臨床需 轴式螺釘2d 合各種固定元件。如此可降低多 體。此外，财容存料，使外觸師可實質選擇植入 以此骨齡件可升等，形成本發背綱定裝置。 稍微偏堡力，故預組裝狀態之螺釘元件頭部施以 下，此舉可改進骨^定手^力以樞_部°在某些情況 同的壓力元件，在骨骼的處置。可提供不 元件，以選擇㈣树可藉選擇適當歷力 201110930 【實施方式】 白。本發明其他特點和優點，由如下參見附圖之說明即可明 第Μ圖所示第一具體例之骨路固定 件，在本例中為螺釘構件 置d 多其他ΞίΓί:之:ί:須知圖示?定機件係舉例，可以ϊ ^ 1' ,. 、疋一件式鎖定機件，並有不同的if %201110930 VI. Description of the Invention: [Technical Field] The present invention relates to a bone fixation device for fixing a stabilizer member to a bone or a vertebra. The bone fixation device includes a fixation element; a receiving member for receiving the head of the bone fixation member, and a receiving stabilizer member coupled to the fixation member. The fixing member is pivotally coupled to the receiving member and is biased to the head by the pressure member to maintain its angle. The fixing member and the pressure member are insertable from the top end of the holder, and once the pressure member is inserted, the magazine member resists the pressure member from coming out through the tip. [Prior Art] US 5,716,356 describes a multi-axis skeletal screw comprising a screw member and a receiving member pivotally connected to the screw member and the pressure member to press the head of the screw member to hold the screw member and the accommodating member The angle. The receiving member has a U-shaped passage to accommodate the stabilizing rod. The pressure element includes a cylindrical recess in which the U-shaped channels are aligned to receive the rod therein. In order to hold the pressure element in the position where the tongue is aligned, the pressure element is squeezed through the cavity provided in the holder to hold its position. US 20_080420 A1 describes a multi-extraction bone screw package in which a base member holds a jaw member in a receiving member and a phase member is pressed against the head of the screw member. The crown element comprises two stop surfaces which help to maintain the crown element in the accommodation = bottom m: r so-called bottom-loading screw, ie screw element WO 2006/116437 A2 - seed bone county fixer, ridge The associated bone screw form 'contains the screw element, the casing', the sleeve and the collet in the casing for pressing against the head of the screw element. In addition, the fastening ribs can be formed in the casing, and the long hole shape is usually carried out in the assembled state of the above-mentioned _ multi-axis type rib nails, such as Xia Shang·201110930. In this state, a special screw member, such as a screw member having a stem diameter of a length and a specific thread form, is disposed therein so that it does not come out. Surgery can be provided with the necessary number and type of such pre-assembled multi-axis skeletal snails. (4) Firstly, the nails are pre-assembled in the pre-assembly state, and the pressure components are available. The position where the cymbal is free to pivot within the accommodating member. Some of these operations do not require such unrestricted pivoting. /, - 4 [Summary of the Invention] The external supply-bone road fixation device' has components that are easily assembled. Material, f-faced placement for the operation of the miscellaneous items in accordance with the _ patent range of the first fixed device. Progress-^ development is listed in the scope of the patent application. Reduce the setting of only a few components. The components are simple to design. So before, set. After the component is manufactured, the screw is inserted into the bone path and the multi-axis bone 2 = bone network. Therefore, any of them, before or during surgery, is a 5仃-疋 surgeon or a modular system that can be used to visualize the clinical requirements of shaft screws 2d with various fixed components. This reduces the number of organisms. In addition, the storage of wealth allows the external contactor to physically select the implant, so that the bone age can be upgraded, etc., forming the hair-backing device. Slightly biased, so the pre-assembled screw element head is applied, which can improve the bone force to fix the force to the same pressure element in the bone. No components can be provided to select (four) trees to choose the appropriate calendar 201110930 [Implementation] White. Other features and advantages of the present invention will be apparent from the following description with reference to the accompanying drawings, in which the bone path fastener of the first embodiment is shown in the drawings. In this example, the screw member is placed in the other. ί: For example, the fixed machine example can be ϊ ^ 1 ' , . , 疋 one-piece locking mechanism, and has different if %
==件=彈簧元件8,形成套合環，把壓力Z 例内特ΐίί二式。在圖示具體 ^ 53 朝底^?0 52縮小，由此且古rt- ca lJr 罝4工 接納頭部4，故可相對於容納件有 3可以貫？。腔孔 2實質土 U形凹部55，藉此形成通道，以容納桿件 。壓m有：f:5 56 ’與鎖定機件的内螺釘7嚙合。 從頂端51插入，並可在容納件5的53 ί 6卜適應聊4尺寸1力^;側面’科球形凹部 狀，諸如平坦表面或二想任何其他形 之表面，可提供分佈於頭部適 =丁f件f部 堅力兀件6有圓_凹部62，適於容納桿件2〇於其 201110930 内。利用此凹部形成通道，以容納桿件。在圖示具體例内， 凹部62深度小於桿件直徑，故内螺釘7可進到與桿件20接 觸。共軸腔孔63延伸穿過壓力元件，可存取工具，旋入到螺 釘元件2内。 壓力元件60又包括環周凹溝64，設在壓力元件外表 面，/於圓筒形凹部62下方。凹溝64截面呈長方形，惟亦可 方形或圓滑之角隅。亦可有其他形狀，例如不對稱形。凹溝 64直徑使其可接納套合環8之一部份。利用長孔63使套人 環具有彈性，直徑可以變化。 σ 壓力元件5包括相對應環周凹溝57，位於通路55底部 斗下方，故當套合環8插入時，即位在桿件以下。凹溝尺 納套合環8。就像壓力元件的凹溝64，容納件内的 有長方形截面，或方形截面，或為圓滑角隅。亦可 為其他形狀，例如不對稱形。 減ί參^ 5至7圖說明套合環8。第一具體例之套合環 小，眚t合環的内徑在底側82較在頂側81 動方向形成不對獅。凹溝57的位 ^插人凹溝内’再將壓力 動。套合環的:力持位置，仍然容許頭部樞 力元件時，會在二擴;果内’在引進Μ 銷宕嬙杜♦-a 直引尝入壓力70件之凹溝64内。 頭部鎖定於容納件ί力凡件向下運動，直到壓住頭部，在 鈦或不銹鋼，體：，料製成，例如 相容性塑膠材料製成，使彈簧元件環 201110930 能。 星形第變化例。套合環8,不是_，而是 ί 和斜面84,，最好位於星形峰邻Η之谷 其他^，例如具有蜂部和谷部之其他;更形環挽性。亦可構想 而凹ί=ίΓ+，物咖可椒方向對稱， 9圖第-步锁如第 内。套人璜8 $宏、、牛内，直至置於凹溝57 人卢t二 向使斜面84朝向容納件5之頂端5卜套 合％ 8在環周方向之定向，佶县 — 晉 的縱軸線呈大約90度。 疋位在相對於通路55 次-步驟如第1G圖所示，螺釘元件和壓力 ίί納彳，1故螺紋幹部3在第二端52通過腔孔53。 w後’如第11圖所示，壓力元件6和頭部 因=通過突入腔孔53内之套合環。由於斜面 = 頂端5卜可以減少螺釘頭部和壓力元件插入 :和壓力兀件的下緣沿斜面84滑動，因而把套合環擴J釘2 力7G件向下推，直到套合環8套人壓力元件之凹溝64内。一 旦套合環接納入凹溝64内，除去壓力元件（即從凹溝64 去套合環）必要之力量即增加，因為凹溝64,57的上部: 有止動件的仙。所以’壓力元件不會落出，也不會經 一端51脫出，除非使用特殊工具。因此，壓力元件和 件的組裝是單向式。 ’' 疋 可以選擇套合環的位置，使壓力元件在預組裝狀態下， 對頭部施以稍微偏壓力。如此，可設不同的壓力元件，例如 具有凹溝的第一壓力元件，位於比第二壓力元件高。在骨骼 固定裝置組裝時，可選擇適當壓力元件，具有所需的偏壓 力。 現有多軸式螺釘之容納件和壓力元件，可設凹溝和套合 201110930 環而升等。 然後吏容絡】J後’把螺釘插入骨絡内。 骨路固定裝置辦餘f有j疋向接納桿件。把連接若干 件，夾持頭％，力Γ以铛〜’方疋緊内螺釘7，〶下推動壓力元 由於斜面84朝第一端51，====: 小力元件的凹溝叫沿二下動壓所需力- 例不體機二具體例與第-具體 指桿59 Λ·’ + 5在—相反侧’有縱向凹部％’内配置彈性 51 %從躺第二端52_部58基底，按第一端 ίίΓ出，分別在凹部58進、出方向撓曲。-因Ϊ二 一端之末^接^^力/件往外麗之彈性指桿59。在其朝第 始Ϊγ末^ ^干有止動表面59a，分別實質上垂直於轴 第一端延^。ί止動表面％的相反側’有傾斜表面59b朝向 面5%向下傾斜，形成滑面，壓力元件可沿此 3之=表面59a區域内的彈性指桿間之内徑，比壓力 ，力7L件6’雜與前述具體例之壓力元件6 ^溝64。屋力元件6,上錢與彈性指桿的止動表面t 株V第^體例骨賴定裝置之組裝步驟為，首先提供容納 ’再將螺釘兀件2連同愿力元件6’，從容納件5,頂端插 H第17圖。壓力元件和頭部往下運動，直至壓力元件碰 J彈性指桿59之上斜面5% ’因而分別把彈性指桿向外壓入 凹部58内。由於傾斜表面5%朝向第一端51，插入力量 小。當壓力元件通過彈性指桿時，即向後套合，由止動表面 59a阻止屢力元件按第一端51方向脫出。所以，壓力元件、 201110930 螺釘元件和容納件的組裝也是單向 具體例可構想進—步修改。例 用各種固定元件，與容納件•且人二對固疋兀件而言，可 長度、不同直徑的螺釘、套其^等固定元件有例如不同 等。 ^釘套官螺釘、不同螺紋形之螺釘、釘 射容目納件，尤指具有不同鎖定元件，例如-件犬 鎖又機件，即具有外螺釘和 件式 定。壓力元件具有桿材用通道件和頭部分別鎖 思其他鎖定機件，諸如外_、較可構 料你狀不限於圖不具體例。例如容納件可右尤 對稱=:^:有不 形狀亦不限於圖示具體例。例如壓力元件可 ϋ ίϊΐη經由錐形斜縮部，對頭部施壓，和/ ί可 部’或具有其他形狀。 ί=Γ固ί裝置第一具體例之透視侧視圖； Ϊ 3=目錄狀裝置岭H舰側視圖； 圖；第3圖為第2圖骨絡固定裝置垂直於桿件轴線之斷面 第4圖為第3圖部份放大圖； 第5圖為第一具體例套合環之透視圖； 第6圖為第一具體例套合環之俯視圖； ，7圖為第6圖套合環沿第6圖Α_Α線之斷面圖； 第8圖為套合環修飾具體例之透視圖； ，9-11圖為第—具體例骨制定裝置組裝步驟斷面圖； 圖為第二具體例骨裝置之透視分解圖； 3圖為第12圖錄ϋ定裝置組餘態之透視圖； 4圖為帛12和13圓所示第二具體例容納之透棚； 圖為第12圖第二具體例骨路固定裝置垂直於桿件 釉綠之斷面圖； 201110930 第16圖為第15圖骨骼固定裝置之部份放大圖； 第17圖為第二具體例骨骼固定裝置之組裝步驟圖。 【主要元件符號說明】 1 骨骼固定裝置 2 螺釘構件 3 螺紋幹部 4 頭部 4,4， 凹部 5,5， 容納件 6,6， 壓力元件 7 内螺釘 8,8， 彈簧元件 20 桿件 51 容納件頂端 52 容納件底端 53 共軸腔孔 54 底座 55 U形凹部 56 陰螺紋 57 凹溝 58 縱向凹部 59 彈性指桿 59a 止動表面 59b 傾斜表面 61 球形凹部 62 圓筒形凹部 63 共軸腔孔 64 凹溝 65 壓力元件上侧 81 套合環頂侧 82 套合環底側 83 從頂側貫穿底侧長孔 84,84s 套合環斜面 Μ 對稱軸線== part = spring element 8, forming a fit ring, the pressure Z is in the case of special ίί2. In the figure, the specific ^ 53 is reduced toward the bottom ^ 0 0 52, and thus the ancient rt- ca lJr 罝 4 work receives the head 4, so it can be 3 with respect to the accommodating member? . The bore 2 is a substantially U-shaped recess 55 whereby a passage is formed to accommodate the rod. The pressure m has: f: 5 56 ' meshes with the inner screw 7 of the locking mechanism. Inserted from the top 51, and can be placed in the 525 of the accommodating member 5; the side of the spheroidal concave shape, such as a flat surface or two other surface, can be provided in the head = dent f-fitting 兀 6 has a round _ recess 62 adapted to accommodate the rod 2 within its 201110930. A channel is formed by the recess to accommodate the rod. In the illustrated embodiment, the depth of the recess 62 is smaller than the diameter of the rod, so that the inner screw 7 can come into contact with the rod 20. The coaxial bore 63 extends through the pressure member and is accessible to the tool and screwed into the screw member 2. The pressure element 60 in turn includes a circumferential groove 64 disposed on the outer surface of the pressure element and below the cylindrical recess 62. The groove 64 has a rectangular cross section, but may also be square or rounded. Other shapes are also possible, such as asymmetrical shapes. The groove 64 is sized to receive a portion of the collar 8 . The long hole 63 is used to make the sleeve ring elastic and the diameter can be varied. The σ pressure element 5 includes a corresponding circumferential groove 57 located below the bottom of the passage 55 so that when the collar 8 is inserted, it is below the rod. Groove ruler. Like the groove 64 of the pressure element, the receiving member has a rectangular cross section, or a square cross section, or a rounded corner 隅. It can also be other shapes, such as an asymmetrical shape. Reduce the 参 ^ 5 to 7 figure to illustrate the fit ring 8. The casing ring of the first specific example is small, and the inner diameter of the 眚t ring forms a lion on the bottom side 82 in the moving direction of the top side 81. The position of the groove 57 is inserted into the groove and the pressure is again applied. The fit ring: When the position is still allowed, the head pivot component is still allowed to expand in the second direction; in the fruit, the introduction of the 宕嫱 ♦ Du ♦-a directly draws into the groove 64 of the pressure 70 pieces. The head is locked in the accommodating member. The sturdy piece moves downward until it is pressed against the head, in titanium or stainless steel, and the body is made of a material such as a compatible plastic material to make the spring element ring 201110930. Star change example. The nesting ring 8, not _, but ί and the slanting surface 84, is preferably located in the valley of the star-shaped peak adjacent to the other, such as other parts with bees and valleys; more shape-looping. It can also be conceived and concave ί=ίΓ+, the food can be symmetrical in the direction of the pepper, and the 9th step-step lock is as in the first. Set of people 璜 8 $ macro, inside the cow, until placed in the groove 57 people Lu t two-way to make the inclined surface 84 toward the top of the accommodating member 5 5 套 fit in the direction of the circumferential direction, Jixian - Jin's vertical The axis is approximately 90 degrees. The clamp is 55 times relative to the passage - the step is as shown in Fig. 1G, the screw member and the pressure are applied, and the threaded stem 3 passes through the bore 53 at the second end 52. After w, as shown in Fig. 11, the pressure element 6 and the head pass through the nesting ring that protrudes into the cavity 53. Since the bevel = top 5 can reduce the insertion of the screw head and the pressure element: and the lower edge of the pressure element slides along the inclined surface 84, so that the sleeve ring expands the J nail 2 force down the 7G piece until the sleeve ring 8 sets The groove 64 of the human pressure element. Once the loop is received into the groove 64, the necessary force is removed to remove the pressure member (i.e., the loop is removed from the groove 64) because the upper portion of the groove 64, 57: has a stop. Therefore, the pressure element will not fall out and will not come out through one end 51 unless special tools are used. Therefore, the assembly of the pressure element and the piece is unidirectional. ’' 疋 The position of the fit ring can be selected so that the pressure element is slightly biased against the head in the pre-assembled state. Thus, different pressure elements can be provided, such as a first pressure element having a groove, located higher than the second pressure element. When assembling the bone fixation device, the appropriate pressure element can be selected to have the required biasing force. The existing multi-axis screw accommodating parts and pressure elements can be provided with grooves and sleeves 201110930 ring and so on. Then 吏容络]J after the 'insert the screw into the bone network. The bone road fixing device has a j-direction to receive the rod member. Connect a number of pieces, hold the head %, force the 铛~' square 内 tightening the inner screw 7, push the pressure element down the sloping surface 84 toward the first end 51, ====: the groove of the small force element is called along The force required for the second dynamic pressure - the example of the non-body machine 2 and the specific - the specific finger 59 Λ · ' + 5 on the opposite side 'there is a longitudinal recess %' configured elastic 51% from the second end 52_ The base 58 is bent at the first end and deflected in the inward and outward directions of the recess 58 respectively. - Because the end of the end of the second end ^ ^ ^ force / piece of the elastic finger 59 to the outside. At the end of the first Ϊγ, there is a stop surface 59a which is substantially perpendicular to the first end of the shaft. ίThe opposite side of the stop surface %' has an inclined surface 59b which is inclined downward toward the surface 5% to form a sliding surface, and the pressure element can be along the inner diameter of the elastic finger in the region of the surface 59a, the specific pressure, the force The 7L piece 6' is mixed with the pressure element 6 of the previous specific example. The housing component 6, the locking surface of the money and the elastic finger, the assembly step of the body of the body of the elastic body, is first provided to accommodate the 'removing the screw member 2 together with the force member 6' from the receiving member 5, the top insert H Figure 17. The pressure member and the head are moved downward until the pressure member hits the bevel 5% of the upper surface of the elastic finger 59, thereby pressing the elastic finger outward into the recess 58 respectively. Since the inclined surface 5% faces the first end 51, the insertion force is small. When the pressure member passes the elastic finger, that is, it is fitted backward, the stopper surface 59a prevents the force member from coming out in the direction of the first end 51. Therefore, the assembly of the pressure element, the 201110930 screw element and the receiving part is also a one-way specific example. For example, with various fixing elements, and for the accommodating member and the two pairs of fixing members, the fixing members such as the length, the different diameter screws, and the sleeve may be different, for example. ^Nail sleeve screws, different thread-shaped screws, nail-capacity parts, especially with different locking elements, such as - dog locks and parts, that is, with external screws and pieces. The pressure element has a passage member for the rod and a head to lock the other locking members, such as the outer _, and the more configurable material is not limited to the specific example. For example, the accommodating member can be right symmetrical =: ^: There is no shape and is not limited to the specific example shown. For example, the pressure element can be pressed against the head via a tapered bevel, and / or can have other shapes. Γ=Γ ί ί 透视 第一 第一 第一 第一 第一 第一 第一 第一 = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = 4 is a partial enlarged view of FIG. 3; FIG. 5 is a perspective view of the first specific example of the fit ring; FIG. 6 is a plan view of the first specific example of the pull ring; A cross-sectional view taken along line Α_Α of Fig. 6; Fig. 8 is a perspective view of a specific example of the modification of the nested ring; and Fig. 9-11 is a sectional view of the assembling step of the specific example of the bone making device; A perspective exploded view of the bone device; 3 is a perspective view of the remaining state of the device group in Fig. 12; 4 is a permeable view of the second specific example shown in 帛12 and 13 circles; Specifically, the bone path fixing device is perpendicular to the cross section of the glaze green of the rod; 201110930, Fig. 16 is a partial enlarged view of the bone fixing device of Fig. 15; and Fig. 17 is a diagram showing the assembling steps of the bone fixing device of the second specific example. [Description of main components] 1 Skeleton fixture 2 Screw member 3 Threaded stem 4 Head 4, 4, recess 5, 5, accommodating part 6, 6, pressure element 7 Internal screw 8, 8, Spring element 20 Rod 51 Housing Top end 52 Housing bottom end 53 Coaxial bore 54 Base 55 U-shaped recess 56 Female thread 57 Groove 58 Longitudinal recess 59 Elastic finger 59a Stop surface 59b Inclined surface 61 Spherical recess 62 Cylindrical recess 63 Coaxial cavity Hole 64 groove 65 pressure element upper side 81 fitting ring top side 82 fitting ring bottom side 83 from the top side through the bottom side long hole 84, 84s fitting ring slope Μ axis of symmetry